THE IMPORTANCE OF RENAL BIOPSY IN PATIENTS WITH DIABETES MELLITUS
Date Issued
2024-04-04
Author(s)
Milenkova Bogojevska M
Memedi, B
Stefanoska Taskoska, G
Stojanoska Severova, A
Abstract
THE IMPORTANCE OF RENAL BIOPSY IN PATIENTS
WITH DIABETES MELLITUS
V. Ristovska, P. Dzekova-Vidimliski, Z. SterjovaMarkovska, M. Milenkova-Bogojevska, B. Memedi, G.
Stefanoska-Taskoska, A. Stojanoska-Severova, Z.
Janevski
Deparment of Nephrology, Faculty of Medicine,
University Sts. Cyril and Methodius Skopje, N.
Macedonia
PP
Introduction. The diagnosis of diabetic kidney disease (DKD) is most often made clinically. However,
there is growing awareness of the prevalence of nondiabetic kidney disease (NDKD) with or without concomitant diabetic nephropathy (DN) in patients with
diabetes. Proteinuria and renal disfunction is common in patients with diabetes mellitus. In most of
the cases diabetic nephropathy is the cause of that
disfunction, but some of the cases present other nondiabetic renal disease. Renal biopsy in diabetic patients has presented variety of glomerular changes.
Immunosuppresants used for treatment of the glomerular diseases may be associated with complications.
Case report. Herein, we review the prevalence and
presentation of NDKD in diabetic patients, with a focus on glomerular lesions, and discuss the ways in
which diabetes can affect the diagnosis and management of these conditions. Diabetic patients with glomerular disease represent a sizable patient population.
We report on 2 cases with diabetes mellitus with nondiabetic kidney disease confirmed with renal biopsy.
The first case was a 58-year-old man, admitted to our
Department with a history of diabetes, with actual
presence of fatigue, inapetence and edema and proteinuria 6 g/24 hours. Renal function was diminished,
creatinine values were 226 micromol/l, with GFR 38
ml/min. Second case was a 53 year -old-man with
edema, hypertension, atrial fibriloflater and breatlessness, was treated with cardiologic therapy, but the
edema was still present. Creatinin value was 126
micromol/l and proteinuria was 4,36 g/l (11,94g/
24hours). In both cases, renal biopsy was performed
and the histopatologic analysis showed membranoproliferaive glomeurlonephritis with presence of diabetic glomerulonephritis.
The patients were treated with corticosteroids as pulse therapy, cyclophosphamide, diuretics and after that
the clinical signs were stabilized.
Conclusion. The authors suggest that the renal biopsy should be performed in diabetic patients with unusual features, such as proteinuria without other signs
of diabetic disorders. Renal histology can be of fundamental importance to both treatment and prognosis
of the disease
WITH DIABETES MELLITUS
V. Ristovska, P. Dzekova-Vidimliski, Z. SterjovaMarkovska, M. Milenkova-Bogojevska, B. Memedi, G.
Stefanoska-Taskoska, A. Stojanoska-Severova, Z.
Janevski
Deparment of Nephrology, Faculty of Medicine,
University Sts. Cyril and Methodius Skopje, N.
Macedonia
PP
Introduction. The diagnosis of diabetic kidney disease (DKD) is most often made clinically. However,
there is growing awareness of the prevalence of nondiabetic kidney disease (NDKD) with or without concomitant diabetic nephropathy (DN) in patients with
diabetes. Proteinuria and renal disfunction is common in patients with diabetes mellitus. In most of
the cases diabetic nephropathy is the cause of that
disfunction, but some of the cases present other nondiabetic renal disease. Renal biopsy in diabetic patients has presented variety of glomerular changes.
Immunosuppresants used for treatment of the glomerular diseases may be associated with complications.
Case report. Herein, we review the prevalence and
presentation of NDKD in diabetic patients, with a focus on glomerular lesions, and discuss the ways in
which diabetes can affect the diagnosis and management of these conditions. Diabetic patients with glomerular disease represent a sizable patient population.
We report on 2 cases with diabetes mellitus with nondiabetic kidney disease confirmed with renal biopsy.
The first case was a 58-year-old man, admitted to our
Department with a history of diabetes, with actual
presence of fatigue, inapetence and edema and proteinuria 6 g/24 hours. Renal function was diminished,
creatinine values were 226 micromol/l, with GFR 38
ml/min. Second case was a 53 year -old-man with
edema, hypertension, atrial fibriloflater and breatlessness, was treated with cardiologic therapy, but the
edema was still present. Creatinin value was 126
micromol/l and proteinuria was 4,36 g/l (11,94g/
24hours). In both cases, renal biopsy was performed
and the histopatologic analysis showed membranoproliferaive glomeurlonephritis with presence of diabetic glomerulonephritis.
The patients were treated with corticosteroids as pulse therapy, cyclophosphamide, diuretics and after that
the clinical signs were stabilized.
Conclusion. The authors suggest that the renal biopsy should be performed in diabetic patients with unusual features, such as proteinuria without other signs
of diabetic disorders. Renal histology can be of fundamental importance to both treatment and prognosis
of the disease
Subjects
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